Asthma first aid: the 4x4x4 plan
By CBD College · Reviewed by our training team · Updated 6 June 2026 · 3 min read
For an asthma attack, sit the person upright and stay calm. Give 4 puffs of a blue/grey reliever inhaler (one puff at a time through a spacer if available, taking 4 breaths after each). Wait 4 minutes; if there's no improvement, give 4 more puffs. If still no improvement, call Triple Zero (000) and keep giving 4 puffs every 4 minutes until help arrives.
Call Triple Zero (000) immediately if the attack is severe or sudden, the person is struggling to breathe or speak, or they have no reliever — then start the 4x4x4 plan.
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